Individual provider Active NPI

Omar Ansari, DDS

  • Dentist
  • Troy, MI
National Provider Identifier
1619316064
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020901 Issued in MI
Practice address
3962 Rochester Rd
Troy, MI 48083-5248
Phone
(248) 429-5555
Fax
(248) 494-4944
NPI assigned
Jun 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020901 MI Primary

Addresses

Primary practice location

3962 Rochester Rd
Troy, MI 48083-5248

Mailing address

28282 Dequindre Rd
Warren, MI 48092-5604
Phone (586) 574-2620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160310000111 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315243854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020901MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Dental Group P.L.L.C. Dentist PastSince Nov 13, 2018 Accepting new patients
Lifetime Dental Care of Michigan, P.C. PastSince Nov 13, 2022 Accepting new patients
Ansari Dental of Troy PLLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1619316064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28282 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925604",
            "telephone_number": "586-574-2620",
            "fax_number": "586-574-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3962 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835248",
            "telephone_number": "248-429-5555",
            "fax_number": "248-494-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "OMAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.